Heartland Pharmacy - Idaho Falls, NPI 1740265420
Long Term Care Pharmacy in Ammon, ID, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1740265420 |
| NPI Entity Type | Organization |
| Provider Name |
Heartland Pharmacy - Idaho Falls
Doing Business As |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Certification Date | September 30, 2009 |
| Provider Location Address | 3250 E 17th St, Ammon, ID, US |
| Provider Mailing Address | 1790 Sabin Dr, Ammon, ID, US, 834066747 |
| Gender | Male |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | Andrea Ferguson |
| Official Position | AUTHORIZED OFFICIAL |
| Phone | 208-497-3575 |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Long Term Care Pharmacy |
| Classification | |
| Group | |
| License No. | 1624LS |
| License State | ID |
| Description | A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 0212857 | MT | MEDICAID | 05 |
| 1740265420 | UT | MEDICAID | 05 |
| 806143700 | ID | MEDICAID | 05 |
| 2021757 | PK | 01 |
Health Information Exchange
| Endpoint Type | Endpoint | Description | Use | Content Type | Affiliation | Location |
|---|---|---|---|---|---|---|
| CONNECT | if | website | DIRECT | OTHER | Yes | 3250 E 17th St, Ammon, ID, US |
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